Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

TTS in BOTH feet

Posted by Rachel G on 4/13/05 at 11:21 (173122)

I have been suffering for 9 months now with TTS in both of my feet. I was a waitress for 12 years and it came on really quickly over a period of 2-4 weeks. I was first diagnossed with PF and tendonitis and givin Celebrex and a cheep orthodic insert. I was told that I would see significant improvement within 2 weeks. Not a chance. I felt a little relif for about 2 days. So on my check up I was told to buy ankle walkers and wear them on both feet. They did help for about 2 weeks then just started causing more pain. After they took Celebrex off the market he then gave me Bextra. I was not impressed with this Pod at that point. My last trip to see him, my mother brought me in because I was in tears and could not walk or stand or even sit with out being in severe pain. He told me that there was nothing more that he could do for me and prescribed me Tylenol-3, which I am allergic to (it was in my records). I was absoulutly outraged. How could a certified Pod that I had seen for 4 months tell me that I just had to deal with the pain because all he could prescribe for me was a drug that I was allergic too? My story is even more depressing then that. That was way back in October. I finally saw a Neurologist in Dec. 2004 and got my diaganossis. Prior to that, i really had no idea what was wrong with me. My anxiety level was severly increased as was my depression. After my diagnosis I decided to get a lawyer since I did not have this problem prior to my last job. Is there anyone else out there that their TTS is work related? At my time of injury I was the main income in the house and we did not have insurance so now we have gone into debt and need to file for bancruptcy, but don't have the money to even to that. My pain is constant and no one will do anything else for me because I do not have insurance and don't qualify for state aid and can not pay for appointments. I have turned my life

Re: TTS in BOTH feet

elliott on 4/13/05 at 11:29 (173123)

Rachel, sorry for your predicament--both the pain and the financial hardship. I too had TTS in both feet. Could you describe your symptoms, e.g., what type of pain you have and where exactly you feel it? Thanks.

elliott

Re: TTS in BOTH feet

lara on 4/13/05 at 12:02 (173128)

Hi Rachel. I had TTS in both feet (still do actually, but it MUCH better). If there is no known cause, such a a mass, to explain you TTS I'd try compression socks. The doctor gave me compression socks, and they were magic for me. Didn't cure me, but did give me a liveable life. Don't think I could be a waitress, and I gave up tennis although early on I swore I wouldn't, but there are other options in life.

As an aside, the doctor only had one compression sock in the office at the time, so he put it on the foot that registered worse on the NCV test, and ordered another one for me. Then it got curious - both feet got better. I did and experiment and put the sock on the other foot and - both feet got worse. Stopped that experiment immediately and put it back on the other foot. So I assume now that I have TTS in one foot, bute because of the pain messaging system in my body it registers as both feet. I've told several doctors about this. The worst ones say it's in my head. The o.k. ones say 'Go figure'. Bodies are wierd'. ONe said 'it's in your head really means 'we don't have a clue'' I like her a lot. But the really good one said 'I've noticed the same thing in other people so now when I give cortisone shots, I only give it in one foot and see what happens before giving it to the other foot.'

Re: TTS in BOTH feet

Jeff S on 4/13/05 at 12:28 (173130)

Rachel, I agree with elliot what kind of symptoms are you having? What state are you in? TTS could very well be work related, if you are in California I may be able to help you with that. If you're not in Ca go see a workmans comp attorney you don't pay them a dime unless you get a settlement. Jeff

Re: TTS in BOTH feet

messed up foot on 4/14/05 at 07:57 (173157)

You might find that when you take control of your own destiny, you will feel emotionally stronger. None of the doctors know you and your body better than you know yourself! It is perfectly OK to get assertive and tell them what you need. All of us with TTS have been in this boat and it is really important to remember that 50% of doctors graduated in the bottom half of their class :-)

Depending on where you live, there are public programs of health insurance or community clinics that see patients on a sliding fee scale. You can get health care, but you will spend a lot of time in waiting rooms. See a lawyer but remember that it will take a LOT of time to resolve a lawsuit.

Neurontin helps nerve pain for some of us. There are other medications besides Tylenol #3 for pain and they work! Last night I saw 'Jobst' stockings in either TravelSmith or Solutions (mags with websites) for only $12 - 20-30 compression! Much more affordable than through a medical supply house. Don't give up on yourself!

Re: TTS in BOTH feet

Rachel G on 4/14/05 at 13:04 (173189)

It starts right off in the morning as soon as I get out of bed. They are both really tight and it hurt to stand, almost as if they are bruised. That's just after I get up. About ten minutes after that the start aching in the arches and up my inner heel/ ankle area and into my achillies area. When I am sitting in a 'normal' chair, my feet start tingling from the arch to the upper ankle on the inside and outside of both feet. Sometimes the pain is on the outer edge of my feet from just bellow my pinky toe down to my heel. I am constantly moving my feet back and forth and around just to 'stretch' them. I don't know if it helps, but it takes my mind off of the pain for a few minutes. Sitting here right now they are tingling all over and pain mostly where my achillies is and my heel area. I tried the neurontin and it did help a bit, but it just got so that I couldn't afford it anymore. I am extremly uncomfortable standing in one spot for more than 5 min. I do not walk through the grociery stores anymore and if I do go someplace that does not have 'go-buggies' available, I usally walk as long as I can (15min) then go and sit in my car and wait for my husband. I never expected anything like this. I also find that my feet a cold more often then not. The only time I am 'comfortable' is when I am sitting upright with my feet on an ottoman or something similar. I feel lazy, but there is nothing I can do without pain or discomfort. I am very dissappointed with the whole situation.
Rachel

Re: TTS in BOTH feet

Rachel G on 4/14/05 at 13:05 (173190)

No one has even mentioned compression socks to me....I will try them. I am willing to try anything at this point.

Re: TTS in BOTH feet

Rachel G on 4/14/05 at 13:07 (173191)

I am in Maine and I did contact a lawyer that is working for me, but it is going to take a really long time before anything happens. I just wish that I could be treated and go back to work doing something. I've been sitting here for 15 minute now and my pain just increased dramaticly. I am knitting and tryin to sell stuff, but even that is depressing because I am just sitting there. I can't even take my step-daughter for a bike ride longer then 10 minutes, then I have to sit for a half hour till I feel a little release of pain. Of corse my claim was denied so now it is a waiting game with no cure until I come upon some money or a Dr that will treat on the condition that he/she will eventually be paid. What are the chances that that is going to happen.

Re: TTS in BOTH feet

Rachel G on 4/14/05 at 13:08 (173192)

Thank you for your support. I need as much as I can get. I just get so frustrated sometimes. It hurts to do dishes. I feel pathetic and I'm sure to others I look that way. I am going to give these compression sock a try.
Rachel

Re: TTS in BOTH feet

elliott on 4/14/05 at 13:28 (173195)

Rachel:

Some but not necessarily all of what you complain about is compatible with TTS. It is strange to get virtually identical symptoms in both feet at the same time from the get-go. The pain in the achilles could be suggestive of structural issues going on. While tingling in the last two toes is common with TTS (with the source being impingement of the nerve at the inner ankle), I'm not sure that's the same as pain on the outer edge of your feet as you describe. Feeling cold could be RSD or indicative of a neuropathy.

I'm babbling somewhat, but your symptoms as you describe them are tough to figure out over the web. I realize the financial problems, but is it possible you could see a good orthopedist for an opinion? He may have other ideas or enlighten you better on how to deal with your problem.

elliott

Re: TTS in BOTH feet

Jeff S on 4/14/05 at 15:45 (173206)

Rachel, you say your claim was denied. Was it denied by your own doctor or your emplyers doctor? Here in Ca we have what is called an AME (agreed medical examiner) you see this doctor when your own says it's work related, and your employers says it's not. The AME is neutral and is unbiased. Some states they call it an IME (independent medical examiner). Your attorney should know the doctors that will see you and take you on a lien basis, if your attorney believes it is work related. In the mean time If you cannot work have your doctor put you on disablity so you will have some form of income. On top of that go to school while you're out because I don't think you'll be going back to your old job. Being out on disability will help you get financial aid for some sort of training to put you back in the work place. take care, Jeff

Re: TTS in BOTH feet

messed up foot on 4/15/05 at 07:53 (173235)

Neurontin recently became available as a generic so it is no longer as expensive.

Have you seen a neurologist? If possible, find one who is also a researcher (try a University). There are all sorts of odd neurologic conditions that could mimic TTS. I think it was Elliot who noted that a bilateral exacerbation of symptoms is odd. He's right unless your real issue is in your spine or central nervous system. Just because your feet hurt (and we ALL believe you when you say they hurt!)doesn't mean that your feet are the source of the pain. A bad disk in your back can refer pain to the end of the nerve and any disease of the nervous system can have very odd symptoms.

I was a waitress while in nursing school and I have no doubt that all those years on my feet in either profession led to my pf and tts. Again - don't give up on yourself!

Re: TTS in BOTH feet

lara on 4/15/05 at 09:31 (173244)

I agree with most of what Elliott says and he gives you a lot of good stuff to think about. I have a small area of disagreement/clarification. I'm not sure it's strange to get virtually identical symptoms. I have virtually identical systems, and the doctor that is familiar with TTS, who diagnosed just from a history (but later confirmed with an NCV test, and this was the fourth doctor) didn't think it was strange. Not common, but it happens.

I finally found a doctor familiar with TTS when I found a doctor that did a lot of sports medicine. It happens to be a podiatrist. I think the more important thing however, regardless of what type of doctor, is whether they are familiar with sports medicine. My experience is they are more familiar with this.

Re: TTS in BOTH feet

Geri on 4/15/05 at 14:39 (173264)

Rachel: You said your feet hurt even doing dishes. I have had tts surgery and use a stool (purchased at Target) for $9.99 or so and bought a little black cushon cover for $5.00 to sit on at the sink, stove and anywhere around the counter I need to do work, and only get up to use the refrig. Hope this helps you.

Re: TTS in BOTH feet

elliott on 4/15/05 at 14:49 (173265)

Lara, I myself had bilateral TTS, confirmed bilaterally at surgery with large veins observed pressing directly on the nerve. I was a runner back then, and would speculate that gait issues (flat feet) led to my troubles, perhaps causing the veins to enlarge. It started in the right foot in 1996 and the left foot in 1999. What is unusual is for one to get it in both feet simultaneously and identically. After all, TTS is entrapment of a nerve at the inner ankle. If not due to a neuropathy, that they should both get trapped at the same time in exactly the same way would be, as you say, not common.

A lot of people come on heelspurs with a diagnosis of TTS, and their symptoms as they describe them are rather vague, often with nary a mention of nervy pain. Throw in that it's bilateral and I would just take it real slow before jumping to a TTS diagnosis. As another poster pointed out, in such cases it is worth also investigating the back as a possible source causing referred pain. One thing I'm not sure about is if one can feel pain in their feet and not have any pain at all in their back or even suspect something's going on there. Some have debated that issue here. I would tend to think they should feel at least something in their back if it's coming from there. What sometimes happens with TTS is that somewhere in the process one gets sciatica and bulging discs are diagnosed. But that could have arisen from altered gait and the like. There is a well-known theory called the double-crush phenomenon, which goes something like this: an impingement in a nerve in the back deprives peripheral nerves of their nourishment, which then leads to things like TTS.

Re: Note to all with TTS in both feet

Ed Davis, DPM on 4/15/05 at 21:27 (173282)

When getting a nerve conduction velocity test (NCV), mkae sure the electromyographer goes up high enough to check the L5.S1 nerve root since that nerve innervates the bottom of the foot.
Ed

Re: TTS in BOTH feet

lara on 4/16/05 at 10:18 (173298)

I guess I agree wtih you that it is not common to get it in both feet simultaneously and identically. Actually, I'll believe you, I have no idea of the numbers - But I don't think it's rare either - based on things my doctor said. That is exactly what I had. Seemed wierd to be at the time, and I asked about it (to several different doctors), and while no one could explain it, some of the doctors had seen it before. My personal best guess is it has to do with the pain/nerve messaging symptoms in the body rather than that the same malady struck both feet exactly at the same time i nthe same way. It's possible. The body is bilateral. But it's not perfectly bilateral. Also treating my right foot helped both feet, and treating the left foot helped neither foot. The doctor, the one who KNOWS TTS wasn't at all bothered by it. While it certainly isn't common, I don't think it's rare.

And while I wouldn't rule out investigating the back, if it looks like TTS from the symptoms, I'd start with non-invasive treatments for TTS &/or PF is that is also being considered. Perhaps while continuing looking for the cause.

Re: TTS in BOTH feet

elliott on 4/16/05 at 23:35 (173320)

Lara, the docs often aren't sure one even has TTS until either obstructions are observed at surgery or else relief is obtained from the release. Yes, I can accept that when something goes haywire in one foot, it makes things more likely to go haywire in the other. I'll reiterate my main point, though: posters often give a long description of the onset of simultaneous identical pain in their feet and make no mention at all of nervy symptoms, which I would think should have been their primary complaint. All I'm saying is, I think they should be real careful before accepting TTS as a definitive diagnosis.

Re: TTS in BOTH feet

lara on 4/17/05 at 10:34 (173330)

I agree with you - if there are no mention of nervy symptoms, TTS is less likely. And I agree I would be very careful before invasive (!!!) or expensive treatments of TTS - even if I KNEW I had TTS. There are some treatments that work for several things that I might try even without a definitive diagnosis. Julie's stretches (if they hurt, you can stop), compression socks (if they hurt you can pull them off), rest, ice, heat, perhaps even some meds if needed to get relief before a definitive diagnosis can be found (some people can't wait for a definitive diagnosis). Unfortunately, this is an area where a lot of good doctors get stumped. At least that was true 5 years and more ago in my town. Perhaps things have improved in the past five years. I wouldn't be surprised.

So I'm not sure I disagree with the major thrust of your posts. Sometimes small things are said, which aren't pertinent to the main point, which people pick up on as indicative of something. I didn't want the questioner, or others who may be following the thread, to think that virtually identical, bilateral symptoms in the foot was strange because I don't think it is. Perhaps you do, and readers can choose which of us they want to believe.

Re: TTS in BOTH feet

Julie on 4/20/05 at 04:55 (173441)

Lara

If you are recommending the foot yoga stretches, you need to say 'foot yoga' which is a direct link. 'Julie's stretches' won't get anyone anywhere! :)
.

Re: TTS in BOTH feet

rose on 4/21/05 at 13:29 (173501)

Cpmpression socks have helped a little with both tts and pf. Try Ames Walker hosiery/ or Ameswalker.com. They have alot of selections that are more comfortable than the jobst

Re: TTS in BOTH feet

Rachel G on 4/24/05 at 14:15 (173650)

workers Comp board denied it because of the date of injury. Because it was a progressive injury. I've got an appt on tues and I will be put on disablity then. i am definitly looking into doing some sort of training in other areas.

Re: TTS in BOTH feet

Rachel G on 4/24/05 at 14:19 (173651)

I did see a neuro. in dec. and he is the one that finally gave me a diagnossis of TTS. I agree that I need more testing but without any insuranse and workman's comp fighting the date of injury I am just waiting. Just waiting for money and income so I can have these tests done. I do agree that I need to have my back looked at too. It just makes sence that it could be coming from there too. So for now im waiting

Re: TTS in BOTH feet

wendy d on 4/24/05 at 22:57 (173677)

I have TTS as well...only in 1 foot at this time. I have worked the past 3 years at a store where I work as an overnight stocker. I'm on my feet all night long. I'd thought about turning it into workman's comp but figured they'd deny and say there was no proof that I got it there. After seeing how you were treated, my guess is I would have got the same answer. It's so unfair......we work our asses off for these people and this is how they thank us! Good luck to you! (I go in tomorrow for my surgery)

Re: TTS in BOTH feet

Kris on 5/15/05 at 00:40 (175054)

COmpression socks drive me crazy. I got some thinking I'd try just anything, but even putting them on hurt me. After about 15 minutes I was about to crawl the wall.

I can't even wear socks, I don't know what made me think I could wear really tight ones.